不同预清洗方法对管腔器械的清洗效果观察

Observation of effects of different cleaning methods for luminal devices

目的探讨不同预清洗方法对放置时间较长、重度污染的管腔器械清洗效果的影响,确定清洗效果最佳的预清洗方法,提高管腔器械清洗消毒质量。方法将2015年6月使用后放置时间>3h的重度污染管腔器械360件,随机分成A、B和C组,每组120件,分别采用不同的方法进行预处理,A组采用超声波清洗预清洗,B组采用手工预清洗,C组不作任何预清洗,将使用不同方法预清洗的器械放入全自动清洗消毒器中,运行手术器械清洗程序,全部清洗程序结束后,所有器械采用带光源放大镜辅助目测和ATP生物荧光检测仪,随机采样检测数据并统计对比。结果器械清洗合格率A组为95.8%,B组为86.7%,C组为66.7%,A组清洗效果最佳,明显优于B组和C组,差异有统计学意义(P<0.001);A组清洗管腔器械,耗时7min,成本为18元;B组清洗管腔器械耗时35min,成本为20元。结论对于放置时间较长的干涸管腔器械,在进入全自动清洗消毒器之前,使用超声波清洗能够显著提高清洗质量,管腔器械的预清洗可首选超声波清洗。

OBJECTIVE To observe the cleaning effects by different methods for longtime stored and severely polluted luminal devices,so as to determine the best pre-treatment cleaning method,and improve the cleaning and disinfection quality of luminal devices.METHODS A total of 360 severely polluted luminal devices which were stored more than 3hours in Jun 2015 were randomly divided into 3groups,with 120 pieces in each group,and were conducted pre-cleaning by different processes.Ultrasonic cleaning pre-treatment were used for group A,hand-washing pre-treatment were used for group B,and no pre-treatment were used for group C.cleaning of surgical instruments procedure was used by putting devices with different pre-treatment into automatic cleaning sterilizer.All the data were randomly selected and compared by visual test with the help of magnifier with light source and ATP bioluminous detector after the cleaning procedures.RESULTS Qualified rates for group A,B,and C were 95.8%,86.7%,and 66.7%,respectively.The cleaning effect for group A was the best,which was much better than that of group B and C（P〈0.001）.In group A,the time was 7min,the cost was 18 yuan,while in group B,the time was 35 min,the cost was 20 yuan.CONCLUSIONIt is necessary to conduct pre-treatment for longtime dried luminal devices before putting into automatic cleaning sterilizer.USC could be the first choice for pre-treatment on medical devices＇ cleaning.